Diet-related Variables Research Articles

The effectiveness of a 6-month intervention with sit-stand workstation in office workers: Results from the SUFHA cluster randomized controlled trial.

Prolonged periods of sitting have been linked to negative health outcomes. Implementation of sit-stand desks in the workplace has been one strategy to reduce prolonged sitting. To assess the effectiveness of sit-stand workstations on reducing sitting time and improving other health outcomes of office-based workers. 39 Portuguese office workers were randomized into a 6-month parallel-group cluster RCT consisting by the implementation of sit-stand desks in the workplace. The primary outcome of sitting time was assessed using ActivPAL. Secondary outcomes included biometric, psychological, and diet-related variables. All outcomes were assessed at baseline and 6 months for the whole sample and at 3 months for a sub-sample of the intervention group (n = 11). No significant time*group interaction was found for the primary or secondary outcomes, apart from waist circumference favoring the control group (Δ-1.81 cm, pinteraction = 0.04). There were significant changes within the intervention group for sitting time (-44.0 min/day), prolonged sitting (>30 min) (-45.3 min/day) and standing time (51.7 min/day) at 3 months in the sub-sample and in prolonged sitting (>30 min) (-26 min/day) in the full intervention group (p < 0.05). Changes were also observed within the intervention group for percent body fat (Δ-3.7%) and ratings of quality of life (Δ2.2), musculoskeletal discomfort (Δ-4.9), overall fatigue (Δ-2.2), and the need for recovery after work (Δ-1.7) at 6-month follow-up (p < 0.05). Although not being effective for reducing sitting time, the implementation of sit-stand desks in the Portuguese workspace was shown to be feasible over the long term, received well by users, and may offer other health benefits. OSF Registration, OSF.IO/JHGPW. Registered 15 November 2022. https://doi.org/10.17605/OSF.IO/JHGPW.

Nutritional Status and its Associated Factors among Government School-Going Adolescents of Birendranagar Municipality, Surkhet, Nepal

WHO recently published report reveals a large number of adolescents in the Southeast Asian Region, who constitute one-fifth (20.0%) of the population in these countries, suffer from malnutrition and anemia, which adversely impact their health and development. If adolescent malnutrition is not treated on time, it leads to major repercussions such as low birth weight and poor health in adulthood. A survey on the nutritional status of adolescents based in 13 districts of Nepal revealed that almost six out of ten male adolescents and seven out of ten(71.0%) of female adolescents were undernourished. The likelihood of undernutrition was high among adolescents residing in Terai (72.0%), followed by Hill (59.0%) and Mountain (54.0%). A cross-sectional descriptive study was carried out among the adolescents of grade 6 studying in the government school of Birendranagar Municipality from May to October 2023. A total of 240 students were selected from five constitute the sample size of the study. The selection was based on stratified random sampling, where each school was considered a stratum. Anthropometric measurement assesses nutritional status based on BMI. Attempts were made to determine the associations between the nutritional status and socio-demographic, behavioral hygiene and diet-related variables. Of the total adolescents, 55.8% were normal, 22.3% were thin and 22.9% were very thin. The nutritional status of the adolescents was observed to be significantly associated with their family type, family income, physical activities, and mother’s education. Encouraging physical activities and promoting healthy habits can enhance the nutritional status of adolescents in the population of students of grade 6 at governmental schools of Birendranagar Municipality, Surkhet, Nepal.

Ethnic variations in metabolic syndrome components and their associations with the gut microbiota: the HELIUS study

BackgroundThe occurrence of metabolic syndrome (MetS) and the gut microbiota composition are known to differ across ethnicities yet how these three factors are interwoven is unknown. Also, it is unknown what the relative contribution of the gut microbiota composition is to each MetS component and whether this differs between ethnicities. We therefore determined the occurrence of MetS and its components in the multi-ethnic HELIUS cohort and tested the overall and ethnic-specific associations with the gut microbiota composition.MethodsWe included 16,209 treatment naïve participants of the HELIUS study, which were of Dutch, African Surinamese, South-Asian Surinamese, Ghanaian, Turkish, and Moroccan descent to analyze MetS and its components across ethnicities. In a subset (n = 3443), the gut microbiota composition (16S) was associated with MetS outcomes using linear and logistic regression models.ResultsA differential, often sex-dependent, prevalence of MetS components and their combinations were observed across ethnicities. Increased blood pressure was commonly seen especially in Ghanaians, while South-Asian Surinamese and Turkish had higher MetS rates in general and were characterized by worse lipid-related measures. Regarding the gut microbiota, when ethnic-independent associations were assumed, a higher α-diversity, higher abundance of several ASVs (mostly for waist and triglyceride-related outcomes) and a trophic network of ASVs of Ruminococcaceae, Christensenellaceae, and Methanobrevibacter (RCM) bacteria were associated with better MetS outcomes. Statistically significant ethnic-specific associations were however noticed for α-diversity and the RCM trophic network. Associations were significant in the Dutch but not always in all other ethnicities. In Ghanaians, a higher α-diversity and RCM network abundance showed an aberrant positive association with high blood pressure measures compared to the other ethnicities. Even though adjustment for socioeconomic status-, lifestyle-, and diet-related variables often attenuated the effect size and/or the statistical significance of the ethnic-specific associations, an overall similar pattern across outcomes and ethnicities remained.ConclusionsThe occurrence of MetS characteristics among ethnicities is heterogeneous. Both ethnic-independent and ethnic-specific associations were identified between the gut microbiota and MetS outcomes. Across multiple ethnicities, a one-size-fits-all approach may thus be reconsidered in regard to both the definition and/or treatment of MetS and its relation to the gut microbiota.

Association of Evening Eating with Sleep Quality and Insomnia among Adults in a Brazilian National Survey

Abstract Objective To examine the association of evening eating clock time, its elapsed time to the midpoint of sleep (TEM), consumption of caffeine and sugary foods, and dinner meal size with sleep quality indicators and insomnia. Methods The present study's participants (n = 2,050; 18–65 y) were part of a population-based research, with virtual data collection. Logistic regression models were fitted to assess differences in the odd ratios (ORs) (95% confidence interval [CI]) of sleep duration &lt; 7 hours, sleep latency &gt; 30 min, poor sleep quality, and insomnia (outcomes) with the evening diet-related variables. Linear regression analyses evaluated differences in sleep duration and latency associated with the same variables. Restricted cubic splines were used to investigate the shape of the association of mealtime and TEM with sleep duration and latency. Results For each hour delay in evening eating and increase in the duration of TEM, the odds of sleep duration &lt; 7 h [OR(95%CI):1.30(1.20,1.40); OR(95%CI):0.51(0.47,0.56)], sleep latency &gt; 30 [OR(95%CI):1.14(1.07,1.22); 0.88(0.83,0.94)], poor sleep quality [OR(95%CI):1.21(1.13,1.30); 0.80(0.76,0.85)] and insomnia [OR(95%CI):1.12(1.04,1.20); 0.89(0.84,0.95)], respectively, increased and decreased. We found a dose-response association of evening eating (clock time and TEM) with sleep duration. The shortest latency was seen when evening eating was at ∼ 8 PM and ∼ 7 to 8 hours before the midpoint of sleep. Participants who reported dinner as their largest meal and consumed caffeine and/or sugary foods/beverages after 6 PM presented higher odds of sleep duration &lt; 7 hours, poor sleep quality, and insomnia. Conclusions Our findings indicate that an early-eating schedule has beneficial sleep effects and that it will be necessary to consider evening eating patterns and timing, along with sleep and circadian hygiene, to improve sleep quality and circadian health.

Microbial Ecology and Metabolism of Emerging Adulthood: Gut Microbiome Insights from a College Freshman Cohort.

The human gut microbiome (GM) undergoes dynamic changes throughout life, transitioning from infancy to adulthood. Despite improved understanding over the past years about how genetics, lifestyle, and the external environment impact the GM, limited research has explored the GM's evolution during late-stage adolescence, especially among college students. This study addresses this gap by investigating the longitudinal dynamics of fecal microbial, functional, and metabolomic signatures in a diverse group of first-year, dormitory-housed college students. A total of 485 stool samples from 246 participants were analyzed, identifying four primary GM community types, predominantly led by Bacteroides (66.8% of samples), as well as Blautia and Prevotella. The Prevotella/Bacteroides (P/B) ratio emerged as a robust GM composition indicator, predictively associated with 15 metabolites. Notably, higher P/B ratios correlated negatively with p-cresol sulfate and cholesterol sulfate, implying potential health implications, while positively correlating with kynurenic acid. Distinct GM transition and stability patterns were found from a detailed longitudinal subset of 93 participants over an academic year. Parasutterella and the Ruminococcus gnavus group exhibited positive associations with compositional variability, whereas Faecalibacterium and Eubacterium ventriosum group displayed negative associations, the latter suggesting stabilizing roles in the GM. Most notably, nearly half of the longitudinal cohort experienced GM community shifts, emphasizing long-term GM adaptability. Comparing individuals with stable community types to those undergoing transitions, we observed significant differences in microbial composition and diversity, signifying substantial shifts in the microbiota during transitions. Although diet-related variables contributed to some observed variance, diet did not independently predict the probability of switching between community types within the study's timeframe via multi-state Markov modeling. Furthermore, exploration of stability within dynamic microbiomes among the longitudinal cohort experiencing shifts in community types revealed that microbiome taxa at the genus level exhibited significantly higher total variance than estimated functional and fecal metabolomic features. This suggests tight control of function and metabolism, despite community shifting. Overall, this study highlights the dynamic nature of the late-stage adolescent GM, the role of core taxa, metabolic pathways, the fecal metabolome, and lifestyle and dietary factors, contributing to our understanding of GM assembly and potential health implications during this life phase.

Opportunities for Examining Child Health Impacts of Early-Life Nutrition in the ECHO Program: Maternal and Child Dietary Intake Data from Pregnancy to Adolescence

BackgroundLongitudinal measures of diet spanning pregnancy through adolescence are needed from a large, diverse sample to advance research on the effect of early-life nutrition on child health. The Environmental influences on Child Health Outcomes (ECHO) Program, which includes 69 cohorts, >33,000 pregnancies, and >31,000 children in its first 7-y cycle, provides such data, now publicly available. ObjectivesThis study aimed to describe dietary intake data available in the ECHO Program as of 31 August, 2022 (end of year 6 of Cycle 1) from pregnancy through adolescence, including estimated sample sizes, and to highlight the potential for future analyses of nutrition and child health. MethodsWe identified and categorized ECHO Program dietary intake data, by assessment method, participant (pregnant person or child), and life stage of data collection. We calculated the number of maternal-child dyads with dietary data and the number of participants with repeated measures. We identified diet-related variables derived from raw dietary intake data and nutrient biomarkers measured from biospecimens. ResultsOverall, 66 cohorts (26,941 pregnancies, 27,103 children, including 22,712 dyads) across 34 US states/territories provided dietary intake data. Dietary intake assessments included 24-h recalls (1548 pregnancies and 1457 children), food frequency questionnaires (4902 and 4117), dietary screeners (8816 and 23,626), and dietary supplement use questionnaires (24,798 and 26,513). Repeated measures were available for ∼70%, ∼30%, and ∼15% of participants with 24-h recalls, food frequency questionnaires, and dietary screeners, respectively. The available diet-related variables describe nutrient and food intake, diet patterns, and breastfeeding practices. Overall, 17% of participants with dietary intake data had measured nutrient biomarkers. ConclusionsECHO cohorts have collected longitudinal dietary intake data spanning pregnancy through adolescence from a geographically, socioeconomically, and ethnically diverse US sample. As data collection continues in Cycle 2, these data present an opportunity to advance the field of nutrition and child health.

Diet and Depression during Peri- and Post-Menopause: A Scoping Review Protocol.

The aim of the proposed scoping review is to describe and summarize studies assessing the associations between diet-related variables and depression in peri- and post-menopausal women. Studies examining the associations between diet-related variables and mental health indicators in women undergoing menopausal transition or in the post-menopausal period will be systematically retrieved via Medline, EMBASE, PsycINFO, Web of Science, and Scopus databases. All articles identified through the database searches will be imported into Covidence. Following the removal of duplicates, two authors will independently perform title and abstract screening, as well as full-text assessment against eligibility criteria. Data will be extracted using tables developed for observational and experimental studies. The methodological quality of randomized trials, cohort and cross-sectional studies, and case-control studies, will be assessed using the Cochrane risk-of-bias (RoB-2) tool, the NHLBI Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies, and the NHLBI Quality Assessment Tool for Case-Control studies, respectively. Data extraction tables will be used to produce two tables summarizing the main characteristics and findings of the studies included in the review. In the proposed review, we will systematically identify and summarize the currently available evidence on the association between diet-related variables and depression in peri- and post-menopausal women. To our knowledge, this is the first review focusing on this subgroup of the population. Protocol registration: osf.io/b89r6.

Food Pantries and Food Deserts: Health Implications of Access to Emergency Food in Low-Income Neighborhoods

Access to emergency food is critical for the survival and health of vulnerable populations, but its importance is not understood in the context of food deserts. Using a cross-sectional survey based on Albany and Troy, New York, we compared the two food desert models, one based on paid (e.g., grocery stores) and the other based on free food options (e.g., emergency food sites such as pantries and soup kitchens). Structural equation modeling was conducted to identify pathways among people’s access to food sites, food consumption patterns, food insecurity, and health conditions. Access to grocery stores did not show significant links to food insecurity or health conditions, whereas access to emergency food, especially time taken to such food outlets, was found to be a significant factor for increased consumption of fresh food. Among the diet-related variables, food insecurity showed the strongest link to negative health outcomes. Access to free or low-cost options needs to be taken into consideration when designing research and practice concerning food deserts, food insecurity, and subsequent health effects.

Heartfulness in Vegans, Vegetarians, and Omnivores

The primary goal of this study was to investigate the relation between the choice of a vegan or vegetarian diet as a criterion of sustainability and the aspect of heartfulness. We also analyzed which demographic, diet-related, and mindfulness practice-related variables could predict the different facets of heartfulness. In total, 419 persons participated. After providing demographic, diet-related, and mindfulness practice-related information, participants completed a gratitude questionnaire, a self-compassion scale, a compassion scale, and an equanimity scale. The results show that vegans and vegetarians indicated higher scores than omnivores in some aspects of heartfulness, such as both self-compassion scales. These effects could not be shown for the two equanimity scales and for the gratitude questionnaire. Most aspects of heartfulness could either be predicted by demographic or diet-related variables. The best predictors of the elements of heartfulness were the ecological, ethical, or health-related reasons for choosing their diet stated by the participants, as well as the importance the participants attached to nutrition. This study provides evidence that vegans and vegetarians scored higher in several aspects of heartfulness. Vegans tended to score even higher than vegetarians. Both demographic and diet-related variables could predict heartfulness.

The impact of alcoholic drinks and dietary factors on epigenetic markers associated with triglyceride levels.

Background: Many epigenetic loci have been associated with plasma triglyceride (TG) levels, but epigenetic connections between those loci and dietary exposures are largely unknown. This study aimed to characterize the epigenetic links between diet, lifestyle, and TG. Methods: We first conducted an epigenome-wide association study (EWAS) for TG in the Framingham Heart Study Offspring population (FHS, n = 2,264). We then examined relationships between dietary and lifestyle-related variables, collected four times in 13years, and differential DNA methylation sites (DMSs) associated with the last TG measures. Third, we conducted a mediation analysis to evaluate the causal relationships between diet-related variables and TG. Finally, we replicated three steps to validate identified DMSs associated with alcohol and carbohydrate intake in the Genetics of Lipid-Lowering Drugs and Diet Network (GOLDN) study (n = 993). Results: In the FHS, the EWAS revealed 28TG-associated DMSs at 19 gene regions. We identified 102 unique associations between these DMSs and one or more dietary and lifestyle-related variables. Alcohol and carbohydrate intake showed the most significant and consistent associations with 11TG-associated DMSs. Mediation analyses demonstrated that alcohol and carbohydrate intake independently affect TG via DMSs as mediators. Higher alcohol intake was associated with lower methylation at seven DMSs and higher TG. In contrast, increased carbohydrate intake was associated with higher DNA methylation at two DMSs (CPT1A and SLC7A11) and lower TG. Validation in the GOLDN further supports the findings. Conclusion: Our findings imply that TG-associated DMSs reflect dietary intakes, particularly alcoholic drinks, which could affect the current cardiometabolic risk via epigenetic changes. This study illustrates a new method to map epigenetic signatures of environmental factors for disease risk. Identification of epigenetic markers of dietary intake can provide insight into an individual's risk of cardiovascular disease and support the application of precision nutrition. Clinical Trial Registration: www.ClinicalTrials.gov, the Framingham Heart Study (FHS), NCT00005121; the Genetics of Lipid Lowering Drugs and Diet Network (GOLDN), NCT01023750.

Impact of growth, gonadal hormones, adiposity and the sodium-to-potassium ratio on longitudinal adolescent measures of blood pressure at puberty.

Blood pressure (BP) rises rapidly at puberty. While this is partly due to normal development, factors like excess adiposity and a high intake of dietary sodium relative to potassium may contribute to a true increase in hypertension risk. This study aimed to assess the relative impact of growth, gonadal hormones, adiposity and the sodium-to-potassium ratio (Na:K) on longitudinal BP measures at puberty. This study analysed data from a three-year longitudinal cohort study of pubertal adolescents. Anthropometry, body composition (bio-electrical impedance), serum testosterone and oestradiol (mass spectrometry) were measured annually. Na:K was measured from three-monthly urine samples. These variables were used to predict annual BP measures using mixed modelling and ordinal regression. Data from 325 adolescents (11.7 ± 1.0 y; 55% male) were analysed, showing typical growth patterns at puberty. Systolic BP increased over time in both sexes (p < 0.01), with boys exhibiting a significantly steeper rise compared to girls. Adiposity variables (BMI z-score, percent body fat, fat mass, waist-to-height ratio) strongly and consistently predicted systolic and diastolic BP in both sexes (all p < 0.05). Systolic BP was also significantly and positively related to height (p < 0.05). No associations with BP were identified in either sex for gonadal hormones or Na:K. Similar results were obtained when BP was classified into hypertension categories. Relative to other developmental and diet-related variables tested, adiposity was found to be the strongest most consistent predictor of BP in pubertal adolescents. Findings highlight the importance of dedicated youth obesity management interventions and policy measures for reducing long-term hypertension and cardiovascular disease risks.Australian New Zealand Clinical Trials Registry ACTRN12617000964314.

Characterizing the urban diet: development of an urbanized diet index

BackgroundIn recent decades China has experienced rapid urbanization leading to a major nutrition transition, with increased refined carbohydrates, added sweeteners, edible oils, and animal-source foods, and reduced legumes, vegetables, and fruits. These changes have accompanied increased prevalence of cardiometabolic disease (CMD). There is no single dietary measure that summarizes the distinct food changes across regions and levels of urbanization.MethodsUsing a sample of adults (≥18 years) in the 2015 wave of the China Health and Nutrition Survey (CHNS; n = 14,024), we selected literature-based candidate dietary variables and tested their univariate associations with overall and within-region urbanization. Using iterative exclusion of select diet-related variables, we created six potential urbanized diet indices, which we examined relative to overall urbanization to select a final urbanized diet index based on a priori considerations, strength of association with urbanization, and minimal missingness. We tested stability of the final urbanized diet index across sociodemographic factors. To examine whether our new measure reflected health risk, we used mixed effects logistic regression models to examine associations between the final urbanized diet index and CMD risk factors – hypertension (HTN), overweight, and type 2 diabetes mellitus (T2DM), adjusting for sociodemographics, overall urbanization, physical activity, and including random intercepts to account for correlation at community and household level.ResultsWe identified a final urbanized diet index that captured dietary information unique to consumption of an urbanized diet and performed well across regions. We found a positive association (R2 = 0.17, 0.01 SE) between the final urbanized diet index and overall urbanization in the fully adjusted model. The new measure was negatively associated with HTN [OR (95% CI) = 0.93 (0.88–0.99)] and positively associated with T2D [OR = 1.13; 1.05–1.21] in minimally adjusted models, but not in the fully adjusted models.ConclusionWe derived an urbanized diet index that captured dietary urbanization that was distinct from overall urbanization and performed well across all regions of China. This urbanized diet index provides an alternative to measures of traditional versus urbanized diet that vary across regions due to different cultural dietary traditions. In addition, the new measure is best used in combination with diet quality measures, sociodemographic, and lifestyle measures to examine distinct pathways from urbanization to health in urbanizing countries.

Triglyceride-Associated Epigenetic Markers and Diet and Lifestyle Habits in the Framingham Heart Study

ObjectivesThe current evidence has shown that environmental and lifestyle factors (e.g., diet, physical activity, tobacco smoking, alcohol) are associated with DNA methylation patterns. However, the mechanisms underlying the relation between diet and other exposures and epigenetic profiles are not well understood. To reduce such knowledge gap, we investigated the links between lifestyle, including diet, and methylation marks with plasma triglyceride concentrations (TG).MethodsWe first conducted an epigenome-wide association study (EWAS) (Illumina HumanMethylation450 BeadChip) for TG in the Framingham Heart Study Offspring population (n = 2,178). We then examined the relationships between dietary and lifestyle-related variables, collected over 13 years, and differential DNA methylation marks associated with the last TG measures (exam 8). Second, we conducted a mediation analysis to examine the potential causal relationship between diet-related variables and TG.ResultsThe EWAS analyses revealed 28 TG-associated DNA methylation sites at 19 regions (e.g., ABCG1, CPT1A, DHCR24, PHGDH, SLC7A11, SLC43A1, SREBF1, TXNIP). Within those methylation sites, we identified 427 significant associations between these DNA methylation sites and one or more dietary and lifestyle-related variables after accounting for multiple testing. The two most significant and consistent associations between TG-associated DNA methylation markers and diet were alcohol (g/day) and carbohydrate intake (% total energy), with P-values ranging from 10^(−4) to 10^(−56). Mediation analyses demonstrated that alcohol and carbohydrate intake independently affect TG via DNA methylation markers as mediators. For seven of the 19 identified differential DNA-methylation regions, higher alcohol intake was associated with decreased methylation and higher TG. In contrast, increased carbohydrate intake was associated with higher DNA methylation at two epigenetic loci (CPT1A and SLC7A11) and lower TG.ConclusionsOur findings indicate that dietary factors (i.e., alcohol and carbohydrate) are associated with specific DNA methylation markers that could mediate some of the observed associations between diet and cardiometabolic risk factors.Funding SourcesThis work was funded by the US Department of Agriculture, under agreement no. 8050-51,000-107-000D.

Nonalcoholic Fatty Liver Disease Induced by High-Fat Diet in C57bl/6 Models

Researchers have a range of animal models in which to study Nonalcoholic fatty liver disease (NAFLD). Induction of NAFLD by a high-fat diet in the C57BL/6 strain is the most widely used among mice. In this study, we review works that performed NAFLD induction by a high-fat diet using the C57BL/6 strain, focusing on experiments on the effects of lipid ingestion. Studies are initially distinguished into researches in which mice received lipids by oral gavage and studies in which lipid was added to the diet, and each of these designs has peculiarities that must be considered. Oral gavage can be stressful for animals and needs trained handlers but allows accurate control of the dose administered. The addition of oils to the diet can prevent stress caused to mice by gavage, but possible changes in the consistency, taste, and smell of the diet should be considered. Regarding the experimental design, some variables, such as animal sex, treatment time, and diet-related variables, appear to have a definite pattern. However, no pattern was found regarding the number of animals per group, age at the beginning of the experiment, time of adaptation, the substance used as a vehicle, and substance used as a control.

Ketogenic diet: Predictors of seizure control.

Background:The ketogenic diet is an effective non-pharmacologic treatment for medically resistant epilepsy. The aim of this study was to identify any predictors that may influence the response of ketogenic diet.Methods:A retrospective chart review for all patients with medically resistant epilepsy was performed at a tertiary care epilepsy center from 1996 to 2012. Patient- and diet-related variables were evaluated with respect to seizure reduction at 1, 3, 6, 9 and 12-month intervals and divided into four possible outcome classes.Results:Sixty-three patients met inclusion. Thirty-seven (59%) reported >50% seizure reduction at 3 months with 44% and 37% patients benefiting at 6-month and 12-month follow up, respectively. A trend toward significant seizure improvement was noted in 48% patients with seizure onset >1 year at 12-month (p = 0.09) interval and in 62% patients with >10 seizure/day at 6-month interval (p = 0.054). An ordinal logistic regression showed later age of seizure to have higher odds of favorable response at 1-month (p = 0.005) and 3-month (p = 0.013) follow up. Patients with non-fasting diet induction were more likely to have a favorable outcome at 6 months (p = 0.008) as do females (p = 0.037) and those treated with higher fat ratio diet (p = 0.034).Conclusion:Our study reports the effectiveness of ketogenic diet in children with medically resistant epilepsy. Later age of seizure onset, female gender, higher ketogenic diet ratio and non-fasting induction were associated with better odds of improved seizure outcome. A larger cohort is required to confirm these findings.

Chronic energy deficiency and associated factors among adults living with HIV in Gondar University Referral Hospital northwest Ethiopia

BackgroundHuman Immunodeficiency Virus (HIV) infection and chronic energy deficiency are bidirectional and multifaceted. HIV can cause or worsen chronic energy deficiency by increasing energy requirements, reducing food intake and nutrient absorption. Chronic energy deficiency weakens the immune system, increase the susceptibility to infections and worsening the disease impact. Studies on the magnitude and factors associated with chronic energy deficiency among adults living with HIV are limited. The aim of this study was to assess the prevalence of chronic energy deficiency and associated factors among adults living with HIV in Gondar University Referral Hospital, northwest Ethiopia.MethodsAn institution based cross-sectional study was conducted and systematic random sampling was used to select study subjects. A total of 317 study subjects were enrolled in the study. Structured and pretested questionnaire was used to collect socio-demographic, economic and diet related variables. Weight and height measurement were taken and medical charts were reviewed. Laboratory analysis for CD4 count and anemia was done. Bi-variable and multi-variable logistic regression analyses were used to assess the effect of different factors on chronic energy deficiency.ResultsA total of 317 patients provide complete information with response rate of 99.4%. The overall prevalence of chronic energy deficiency was 18.3% (95%CI: 14.5%–22.7%). The prevalence of mild, moderate and severe chronic energy deficiency was 11.4, 3.5 and 3.5% respectively. No formal education (AOR = 2.05,95%CI:1.01,4.21), being in the WHO clinical stage three and four (AOR = 3.84,95%CI:1.39,10.61) and history of diarrhea in the last two weeks prior to the survey (AOR = 4.43,95%CI:1.83,10.72) were significantly associated with chronic energy deficiency.ConclusionThe prevalence of chronic energy deficiency among adults living with HIV was medium public health problem. Educational status, WHO clinical stage, and history of diarrhea in the last two weeks prior to the survey were risks for chronic energy deficiency. Integration of nutritional management with HAART, early diagnosis and treatment of diarrheal disease would be supreme important.

Dietary patterns in French home-living older adults: Results from the PRAUSE study

The aim of the present study was to provide descriptive dietary patterns of home-living older adults, and to examine their association with sociodemographic and ‘diet-related’ variables, and health and psychological factors. Dietary patterns were analyzed using separately cluster analysis for men (N=151,Mage=72.72, SD=8.80, range=56-97) and women (N=251, Mage=76.74, SD=9.95, range=55-97) in 402 older adults aged 55 years and over. Cluster analyses showed four distinct dietary profiles for each gender. In older men, the four distinct dietary clusters were associated with any differences in sociodemographic and diet-related variables, cognitive function, and health and psychological factors. Likewise, in older women, the four distinct dietary clusters were associated with any differences in sociodemographic and ‘diet-related' variables’. However in older women, results showed that the cluster 1 “high fish-fruit-vegetable” was associated with a better cognitive function, a better self-rated health and no depressive symptoms, whereas cluster 3 “moderate ready meals” was associated with cognitive decline, slight depression, and poor perceived health. Results emphasize the interest to take into consideration health and psychological factors associated with dietary patterns to better target the vulnerability of individuals and enable an effective prevention.

Acculturation and Dietary Change in Mexican-American Immigrant Women

Our study explored the process of acculturation among Mexican women living in southwest U.S., and the consequences regarding dietary risk factors associated to health. The cross-sectional study included face to face interviews with 150 migrant women and 150 non-migrant women. Interviews consisted of two non-consecutive 24-hour recalls, and data on anthropometry, acculturation, dietary change and lifestyle. Multiple regression analysis showed that consumption of calories from saturated fat and body mass index (BMI) were significantly higher in migrant women compared to non-migrant women, even after adjusting for other lifestyle and diet related variables. Overall, acculturation seems to be associated with more access to food rather than with a change in consumption of dietary risk components. Furthermore, acculturation was associated positively with socioeconomic status, indicating interplay of socioeconomic and cultural variables related to eating behavior in Mexican immigrant women. Positive association of BMI with acculturation and of acculturation with socioeconomic status suggests that health risk factors among Mexican immigrant women follow similar trends of those of women in their born country.

Women's social eating environment and its associations with dietary behavior and weight management

As an unhealthy social eating environment is considered a risk factor for obesity, this study aimed to examine women's regular eating networks and the extent to which diet-related variables were associated with those of their regular eating companions. In Study Part I (N = 579), an egocentric network approach was used to investigate women's perceptions of their eating networks. In Study Part II (N = 262), the participants' most important eating companions responded to a similar survey, and the corresponding answers were matched. The results showed that women shared their meals most frequently with spouses and other family members. Women who dined more often with healthy eaters reported on average a higher diet quality and a lower body mass index (BMI), which were also significant after controlling for individual factors. Study Part II expanded these results by showing that different diet-related factors such as diet quality, eating styles and BMI were correlated between women and their most important eating companions (r = 0.16–0.30, p < 0.05). Moreover, an actor–partner interdependence model revealed that a higher diet quality of the eating companions was associated with a lower BMI in women, controlled for their own eating behavior (b = −0.45, p < 0.05). This study showed similarities and interdependence between women's dietary behavior and body weight and those of their regular eating companions. This might indicate that regular eating networks have a shared understanding of what constitutes a normal diet, which might be an important factor to consider in the promotion of healthy eating.

Neighborhood Socioeconomic Circumstances and the Co-Occurrence of Unhealthy Lifestyles: Evidence from 206,457 Australians in the 45 and Up Study

BackgroundResearch on the co-occurrence of unhealthy lifestyles has tended to focus mainly upon the demographic and socioeconomic characteristics of individuals. This study investigated the relevance of neighborhood socioeconomic circumstance for multiple unhealthy lifestyles.MethodAn unhealthy lifestyle index was constructed for 206,457 participants in the 45 and Up Study (2006–2009) by summing binary responses on smoking, alcohol, physical activity and five diet-related variables. Higher scores indicated the co-occurrence of unhealthy lifestyles. Association with self-rated health, quality of life; and risk of psychological distress was investigated using multilevel logistic regression. Association between the unhealthy lifestyle index with neighborhood characteristics (local affluence and geographic remoteness) were assessed using multilevel linear regression, adjusting for individual-level characteristics.ResultsNearly 50% of the sample reported 3 or 4 unhealthy lifestyles. Only 1.5% reported zero unhealthy lifestyles and 0.2% had all eight. Compared to people who scored zero, those who scored 8 (the ‘unhealthiest’ group) were 7 times more likely to rate their health as poor (95%CI 3.6, 13.7), 5 times more likely to report poor quality of life (95%CI 2.6, 10.1), and had a 2.6 times greater risk of psychological distress (95%CI 1.8, 3.7). Higher scores among men decreased with age, whereas a parabolic distribution was observed among women. Neighborhood affluence was independently associated with lower scores on the unhealthy lifestyle index. People on high incomes scored higher on the unhealthy lifestyle index if they were in poorer neighborhoods, while those on low incomes had fewer unhealthy lifestyles if living in more affluent areas.InterpretationResidents of deprived neighborhoods tend to report more unhealthy lifestyles than their peers in affluent areas, regardless of their individual demographic and socioeconomic characteristics. Future research should investigate the trade-offs of population-level versus geographically targeted multiple lifestyle interventions.